Spinal pain and associated factors among young motorcyclists a cross-sectional study with mediating analysis

Spinal pain is a common musculoskeletal complaint among young adults and is sometimes influenced by lifestyle and behavioral factors. Motorcycles are the most common and convenient means of transportation in India, especially among the younger population. This study aimed to estimate the prevalence of spinal pain among young motorcycle riders and examine the predictors associated with spinal pain, while exploring the statistical mediating role of body mass index (BMI). The study was conducted at a large multidisciplinary higher education institution in India with approximately 60,000 students across 300 programs. As motorcycles are one of the common modes of transport, 422 eligible motorcycle riders were recruited for this study. Data were collected using systematic random sampling, a structured expert-validated questionnaire, and physical measurements. Bivariate and multivariate binary logistic regression model analysis was used to identify factors associated with spinal pain. A bootstrapped mediation analysis was performed to determine the extent to which the mediator variable (i.e., BMI) explained the association between the riding frequency and spinal pain. The overall cumulative prevalence of self-reported spinal pain experienced in the past year was 37.7% (95% CI: 32.7, 42.5). Factors like obesity (AOR 6.24, 95% CI: 1.9, 20.49), being overweight (AOR 2.78, 95% CI: 1.21, 6.37), not engaging in regular physical activity (AOR 2.24, 95% CI: 1.44, 3.48), experiencing fatigue while driving (AOR 2.66, 95% CI: 1.62, 4.42), and being female (AOR 1.87, 95% CI: 1.47, 2.97) were significantly associated with the likelihood of self-reported spinal pain among young motorcyclists in a multivariate logistic model with the level of significance set at 0.05. Furthermore, BMI appeared to partially explain the relationship between bike riding and spinal pain. Spinal pain was common among young motorcycle riders, and it is associated with higher BMI, riding fatigue, and physical inactivity. BMI partially explained the association between riding frequency and spinal pain. The findings highlight the potential importance of healthy body weight, regular physical activity, and addressing riding-related fatigue as part of spinal health strategies among young motorcycle riders.